Korean Journal of Nephrology 2009;28(2):122-126.
Clinical Characteristics of Renal Insufficiency Patients with Clostridium difficile-Associated Pseudomembranous Colitis
Sung Won Jung, M.D.1, Yu Min Lee, M.D.1, Duk Eun Jung, M.D.1, Jae Hoon Lee, M.D.1, Hyun Jung Kim, M.D.1, Ji Eun Lee, M.D.1, Ju Hung Song, M.D.1, Do Sim Park, M.D.2 and Seon Ho Ahn, M.D.1
Department of Internal Medicine1
Department of Laboratory Medicine2 Wonkwang University School of Medicine, Iksan, Jeonbuk, Korea
임상연구 : 신기능 저하 환자에서 위막성 대장염 발생의 임상적 특징
정성원1, 이유민1, 정덕은1, 이재훈1, 김현정1, 이지은1, 송주흥1, 박도심2, 안선호1
원광대학교 의과대학 내과학교실1, 진단검사의학과2
Abstract
Purpose:Clostridium difficile-associated diarrhea (CDAD) is a potentially life-threatening illness which has been shown to be more common and more severe in patient with chronic renal failure. The aim of this study was to investigate clinical characteristics of renal insufficiency patients with clostridium difficile-associated pseudomembranous colitis. Methods:We reviewed charts of fifty-six patients with clostridium difficile-associated pseudomembranous colitis, who have clostridial toxin A assay in stool and a diagnosis made on histology of colonic biopsies. Results:There was no difference in age, serum albumin, C-reactive protein (CRP) and negative incidence of clostridial toxin A between patients who had renal insufficiency with serum creatinine more than 1.5 mg/dL and those who did not. But duration of antibiotic use administered prior to development of the clostridium difficile infection was more shorter in patients with impaired renal function than in patients with normal renal function. Conclusion:These data suggest that it may take a short period to development of the clostridium difficile infection in patients with impaired renal function, and histologic evaluation by sigmoidoscopy should be performed to make a diagnosis in CDAD-suggested patients, who have impaired renal function and even negative clostridial toxin A.
Key Words: Clostridium difficile-associated diarrhea, Pseudomembranous colitis, Renal Insufficiency


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